CPTSD – Complex Post Traumatic Stress Disorder

Recommended DSM diagnostic criteria, per Trauma and Recovery by Judith Herman, ©1992 by Basic Books.

A history of subjection to totalitarian control over a prolonged period (months to years). Examples include:

  • Hostages
  • Prisoners of war
  • Concentration-camp survivors
  • Survivors of some religious cults
  • Persons subjected to totalitarian systems in sexual and domestic life, including:
    • survivors of domestic battering
    • childhood physical or sexual abuse
    • organized sexual exploitation.


  • Alterations in affect regulation, including:
    • persistent dysphoria
    • chronic suicidal preoccupation
    • self-injury
    • explosive or extremely inhibited anger (may alternate)
    • compulsive or extremely inhibited sexuality (may alternate)


  • Alterations in consciousness, including:
    • amnesia or hyperamnesia for traumatic events
    • transient dissociative episodes
    • depersonalization/derealization
    • reliving experiences, either in the form of intrusive post-traumatic stress disorder symptoms or in the form of ruminative preoccupation


  • Alterations in self-perception, including:
    • sense of helplessness or paralysis of initiative
    • shame, guilt, and self-blame
    • sense of defilement or stigma
    • sense of complete difference from others (may include sense of specialness, utter aloneness, belief no other person can understand, or nonhuman identity)


  • Alterations in perception of perpetrator, including:
    • preoccupation with relationship with perpetrator (includes preoccupation with revenge)
    • unrealistic attribution of total power to perpetrator (caution: victim’s assessment of power realities may be more realistic than clinician’s)
    • idealization or paradoxical gratitude
    • sense of special or supernatural relationship
    • acceptance of belief system or rationalizations of perpetrator


  • Alterations in relations with others, including:
    • isolation and withdrawal
    • disruption in intimate relationships
    • repeated search for rescuer (may alternate with isolation and withdrawal)
    • persistent distrust
    • repeated failures of self-protection


  • Alterations in systems of meaning:
    • loss of sustaining faith
    • sense of hopelessness and despair


  1. My ex used the Bible, people at church, people at his job, and he even convinced a counselor i was seeing, that he was practically perfect and that i was the crazy one. He was a total narciscist. He was emotionally and mentally abusive. He thru our dog down our stairs, punched holes in the walls, and wanted me to do things in the bedroom that i didnt want to do, butmade me feel like in order to be a “good Christian wife” i would do what he wanted. one time i felt like i had been raped. All this was so he could maintain his image as a teacher while being a pedophile. i was always the one who was in the wrong, and he was always right. I got rid of him about 8 yrs ago, but it feels like yesterday. To make matters even worse, he looked at kiddie porn and wanted to destroy the computer. I called the cops on him, but they didnt even send it to a place that specializes in getting this crap off the hard drive. They gave the damn thing back to him! It took so much for me to call them and then the detective gave it back to him, only because i wouldnt come in and talk to him when he wanted me to before talking to a lawyer for myself. He was just as psycho as my ex. Most of the time PTSD treatment is for soldiers, but what about people like me? I’m leary of going to a counselor again because of what happened with the other one. i went to another one, but she kept falling asleep or blamimg my mom for stuff. So here i am, i cant remember the last time i slept all night. No drs. will refill sleeping pills for me. i have many of the symptoms you describe.

    • Hi. I am sorry for all the suffering you have been through. And to have a counsellor be convinced that you were the one to blame is sad. Perhaps you can go to the following blog. Healmyptsd.com. She can actually be contacted and has some great information. She wasn’t diagnosed with ptsd for 24 years. She has convinced me healing is possible. Take care of yourself and don’t believe any of the lies your husband told you or that your counsellor fell for. You need healing and sleep!

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